Comparison of infusion of dexmedetomedine and magnesium sulfate on the stability of hemodynamic status during emergency orthopedic surgery: a randomized double-blind clinical trial

Objective: Preparing patients for emergency surgeries requires accurate consideration of their clinical condition and medical history to avoid potential hemodynamic instability and compromise the immune system. This study aims to compare the effects of dexmedetomidine and magnesium sulfate infusions in maintaining stable hemodynamics during emergency orthopedic surgery. Methods: The present study was conducted as a randomized and double-blind clinical trial with the participation of 80 patients who were candidates for an emergency orthopedic surgery during 2021. Magnesium sulfate was administered as an intravenous bolus at a loading dose of 50 mg/kg over 10 minutes, followed by a continuous infusion at a rate of 15-20 mg/kg/hour. Dexmedetomidine was administered as an intravenous bolus at a loading dose of 1 mcg/kg over 10 minutes, followed by a continuous infusion at a rate of 0.2-0.7 mcg/kg/hour, depending on patient response. These infusions were initiated 15 minutes before induction of anesthesia and continued until the end of surgery. All drugs (dexmedetomidine and magnesium sulfate) were diluted in a 50-cc syringe and infused. The hemodynamic status (diastolic blood pressure (DBP), systolic blood pressure (SBP) mean arterial pressure (MAP) and heart rate (HR)) of the patients between the two groups was recorded and finally compared with each other. Results: The hemodynamic status (DBP, SBP, MAP and HR) between the two groups at all (perioperative time) times were without significant statistical differences (P>0.05). Conclusion: Both dexmedetomidine and magnesium sulfate are effective and safe options for achieving hemodynamic stability during emergency orthopedic surgery.